Tobacco use in first-episode psychosis, a multinational EU-GEI study.

BACKGROUND: Tobacco is a highly prevalent substance of abuse in patients with psychosis. Previous studies have reported an association between tobacco use and schizophrenia. The aim of this study was to analyze the relationship between tobacco use and first-episode psychosis (FEP), age at onset of psychosis, and specific diagnosis of psychosis. METHODS: The sample consisted of 1105 FEP patients and 1355 controls from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. We assessed substance use with the Tobacco and Alcohol Questionnaire and performed a series of regression analyses using case-control status, age of onset of psychosis, and diagnosis as outcomes and tobacco use and frequency of tobacco use as predictors. Analyses were adjusted for sociodemographic characteristics, alcohol, and cannabis use. RESULTS: After controlling for cannabis use, FEP patients were 2.6 times more likely to use tobacco [p ⩽ 0.001; adjusted odds ratio (AOR) 2.6; 95% confidence interval (CI) [2.1-3.2]] and 1.7 times more likely to smoke 20 or more cigarettes a day (p = 0.003; AOR 1.7; 95% CI [1.2-2.4]) than controls. Tobacco use was associated with an earlier age at psychosis onset (ß = -2.3; p ⩽ 0.001; 95% CI [-3.7 to -0.9]) and was 1.3 times more frequent in FEP patients with a diagnosis of schizophrenia than in other diagnoses of psychosis (AOR 1.3; 95% CI [1.0-1.8]); however, these results were no longer significant after controlling for cannabis use. CONCLUSIONS: Tobacco and heavy-tobacco use are associated with increased odds of FEP. These findings further support the relevance of tobacco prevention in young populations.

Método para establecer la reserva funcional de la velocidad de marcha en una muestra de adultas mayores autosuficientes chilenas: la relevancia del estímulo / Method to establish the functional reserve of gait speed in a sample of self-reliant older Chilean women: The relevance of the stimulus

Antecedentes y objetivo: El envejecimiento como proceso complejo y multifactorial involucra cambios multisistémicos asociados al rendimiento físico con pérdida de funcionalidad, tal como la velocidad de marcha y su reserva. El estudio estableció el método que mejor evidencia la reserva funcional de velocidad de marcha (RFVM) según la incorporación de estímulos en mujeres adultas mayores (AM). Material y método: Estudio observacional analítico con muestra conformada por 30AM de entre 65-69años, autosuficientes sin riesgo, normopeso y sin sospecha de depresión, controladas en Centro Comunitario de Salud Familiar y Centro de Salud Familiar de Talca. La velocidad de marcha (VM) fue medida a través de tres métodos: M1 (marcha habitual), M2 (marcha máxima) y M3 (marcha máxima con estímulos), para posteriormente calcular la RFVM en las AM. El ejercicio se ejecutó en una pista de 10m que incluía 2m de aceleración, 2m de desaceleración y 6m centrales para medir el tiempo en segundos que demoraba en recorrerlos. Resultados: Las medias de velocidades de la muestra en los métodos habitual, máxima y máxima con estímulo fueron de 1,17, 1,38 y 1,57m/s, respectivamente; las reservas funcionales (RF) resultantes entre las diferencias de los métodos fueron: RF-A (M2−M1) 0,26m/s; RF-B (M3−M1) 0,45m/s y RF-C (M2−M3) 0,19m/s; para la mayoría de los casos y según orden correspondiente, las diferencias estadísticas fueron significativas. Conclusión: El método que mejor evidenció la RFVM fue a través de las diferencias de medias entre M3 y M1, siendo una forma objetiva de verificar esta dimensión del movimiento humano como expresión de funcionalidad de las AM. (AU)

Background and objective: Aging as a complex and multifactorial process involves multisystemic changes associated with physical performance with loss of functionality such as walking speed and reserve. The study established the method that best evidences the functional reserve (FR) of walking speed (FRWS) according to the incorporation of stimuli in older adults (OAs). Material and method: Analytical observational study with a sample made up of 30OAs between 65 and 69years, self-administered without risk, normal weight and without suspicion of depression, controlled in Centro Comunitario de Salud Familiar and Centro de Salud Familiar of Talca. The walking speed (WS) was measured by three methods: M1 (usual gait), M2 (maximum gait) and M3 (maximum gait with stimuli); to later calculate the FRWS in the AO, executed on a 10m track that included 2m acceleration, 2m deceleration and 6m centrals to measure the time in seconds it took to travel them. Results: The mean velocities of the sample in the usual, maximum and maximum stimulated methods were 1.17, 1.38 and 1.57m/s respectively; the resulting FRs between the method differences: FR-A (M2−M1) 0.26m/s; FR-B (M3−M1) 0.45m/s and FR-C (M2−M3) 0.19m/s, for most of the cases and according to the corresponding order, the statistical differences were significant. Conclusion: The method that best evidenced the FRWS was through the differences in means between M3 and M1, being an objective way to verify this dimension of human movement as an expression of OA functionality. (AU)

Evaluación del videolaringoscopio TruviewPCD para la intubación de niños / Assessment of TruviewPCD videolaryngoscope for intubation in children

Objetivo. El objetivo de este estudio observacional y prospectivo fue evaluar la utilidad de TruviewPCD para la intubación pediátrica en la práctica clínica y generar datos para nuevos estudios. Material y método. Incluimos 86 niños consecutivos intervenidos de cirugía otorrinolaringológica, pediátrica o ambas, bajo anestesia general con intubación orotraqueal. Los niños que presentaban 2 o más criterios de dificultad para el manejo de la vía aérea se excluyeron del estudio. Realizamos análisis estadístico descriptivo. Resultados. Ochenta y tres pacientes se intubaron con TruviewPCD. Datos demográficos: edad 4,9 (2,8) años, peso 19,5 (7,7)kg. Setenta y nueve niños se intubaron en el primer intento y 4 en 2 intentos. El tiempo necesario para obtener la mejor visión glótica posible fue (media y desviación estándar) 10,8 (5,6)seg y el tiempo de intubación total (mediana y distancia intercuartil 25-75%) fue de 30 (27,9-37)seg. La intubación fue catalogada como fácil o muy fácil en 81 pacientes. No se registró ninguna complicación importante. Conclusiones. Concluimos que TruviewPCD es un buen dispositivo para el manejo de la vía pediátrica. Sería interesante disponer de un tamaño de pala intermedio, entre la 1 y la 2, ya que hay una diferencia considerable de tamaño entre ambas (AU)

Objective. The aim of this observational prospective study was to evaluate the usefulness of TruviewPCD for tracheal intubation in clinical practice, and to provide data for future studies. Material and method. A study was conducted on 86 consecutive children undergoing ear, nose and throat (ENT) or paediatric procedures under general anaesthesia with tracheal intubation. Children with two or more difficult airway criteria were excluded. A descriptive statistical analysis was performed. Results. Eighty-three patients were successfully intubated with TruviewPCD. Demographic data: Age 4.9 (2.8) years, weight 19.5 (7.7)kg. Seventy-nine children needed one attempt and four required two attempts at intubation. Time for glottis view and tracheal intubation was 10.8 (5.6) and 30 [27.9-37] seconds, respectively. Eighty-one patients were classified as easy or very easy to intubate, and only two cases were considered difficult. No significant complications were registered. Conclusions. TruviewPCD is a good device for paediatric airway management. It would be interesting to have an intermediate blade between size 1 and 2, as the difference between both is too wide (AU)

Assessment of TruviewPCD videolaryngoscope for intubation in children. / Evaluación del videolaringoscopio TruviewPCD para la intubación de niños.

OBJECTIVE: The aim of this observational prospective study was to evaluate the usefulness of TruviewPCD for tracheal intubation in clinical practice, and to provide data for future studies. MATERIAL AND METHOD: A study was conducted on 86 consecutive children undergoing ear, nose and throat (ENT) or paediatric procedures under general anaesthesia with tracheal intubation. Children with two or more difficult airway criteria were excluded. A descriptive statistical analysis was performed. RESULTS: Eighty-three patients were successfully intubated with TruviewPCD. Demographic data: Age 4.9 (2.8) years, weight 19.5 (7.7)kg. Seventy-nine children needed one attempt and four required two attempts at intubation. Time for glottis view and tracheal intubation was 10.8 (5.6) and 30 [27.9-37] seconds, respectively. Eighty-one patients were classified as easy or very easy to intubate, and only two cases were considered difficult. No significant complications were registered. CONCLUSIONS: TruviewPCD is a good device for paediatric airway management. It would be interesting to have an intermediate blade between size 1 and 2, as the difference between both is too wide.

Casos clínicos en Cardiología (nº 12): arritmia neonatal / Clinical cases in Cardiology (Nº. 12): neonatal arrhythmia

Continuamos con la serie de casos clínicos en Cardiología pediátrica presentados de forma breve y práctica y tratando de mostrar la utilidad del electrocardiograma, método diagnóstico del que disponemos en Atención Primaria. En este número se presenta el caso de un recién nacido con arritmia en el periodo perinatal. Se discuten los hallazgos electrocardiográficos y la orientación en el manejo de este paciente (AU)

We continue the series of clinical cases in Pediatric Cardiology. They are presented briefly and practically and trying to show the usefulness of the electrocardiogram, diagnostic method available in primary care. In this issue we present the case of a newborn with arrhythmia in the perinatal period. Electrocardiographic findings and guidance in the management of this patient are discussed (AU)

Intraparenchymal schwannomas: report of two new cases studied with MRI and review of the literature.

Intraparenchymal schwannomas are very rare tumours. We present two young adult patients operated for this type of lesion who show no signs of recurrence 2 years after surgery. These tumours have a bimodal peak of presentation: most occur in young patients under 25 years, and the rest present in the elderly. Characteristically they show both Antoni A and Antoni B areas, intense inmunoreactivity to S-100 and Vimentin protein, and none to EMA or CD34. Electron microscopy is diagnostic when basal membrane is found around the cytoplasmatic processes. MRI spectroscopy depicts increased myoinositol, choline and lipids, and perfusion MR demonstrates high rCBV with a characteristic curve due to the total absence of blood brain barrier. An origin in the Schwann cells of the perivascular nervous plexus in the subarachnoid space is the most accepted theory for the histogenesis of these tumours. We propose to perform the characterization of a series of markers such as SOX-10 in every new case in order to prove that theory.

Mortalidad materna 1991–2007. Por qué mueren las madres en un hospital de tercer nivel / Maternal mortality 1991–007. Why mothers die in a third level hospital

Objetivos Crear un registro de mortalidad materna en nuestro centro, analizar las causas e introducir medidas correctivas para reducir su frecuencia. Material y método Estudio longitudinal retrospectivo de los casos de muerte materna ocurridos en nuestro centro entre enero de 1991 y diciembre de 2007.Resultados Se registraron un total de 128.262 recién nacidos vivos y 25 muertes maternas en el periodo de estudio. Nuestra tasa de mortalidad materna es de 19,4 por 100.000 recién nacidos vivos. El 88% de las madres tenían más de 20 años. El 64% eran primíparas y el 32% multíparas. El 60% tenían entre 22 y 37 semanas en el momento del parto. El 52% de las muertes fueron obstétricas indirectas y el 48% obstétricas directas. No hubo casos de muerte accidental. Conclusiones La tasa de muerte materna es de 19,4 por 100.000 recién nacidos vivos en nuestro centro. La causa más frecuente de muerte materna es la hemorragia puerperal asociada a shock hipovolémico, seguida del shock séptico y el accidente cerebrovascular (A)

Objectives To create a record of maternal mortality in our center, analyze the causes of mortality, and implement corrective measures to reduce the frequency of maternal death. Material and method We performed a longitudinal retrospective study of maternal deaths recorded in our department between January 1991 and December 2007.ResultsA total of 128,262 live newborns and 25 maternal deaths were recorded in the study period. The maternal mortality rate in our center was 19.4 per 100,000 live newborns. Eighty-eight percent of the mothers were aged over 20 years old. Sixty-four percent were primiparous and 32% were multiparous. Sixty percent were between 22 and 37 weeks of pregnancy at the time of delivery. Fifty-two percent were indirect obstetric deaths and 48% were direct obstetric deaths. There were no accidental deaths. Conclusions The maternal death rate in our hospital is 19.4 per 100,000 live newborns. The most common cause of maternal death was puerperium hemorrhage associated with hypovolemic shock, followed by septic shock and stroke (AU)

[Embolization of indirect carotid-cavernous sinus fistula through the ophthalmic vein]. / Embolización de fístula cavernosa indirecta a través de la vena oftálmica superior.

Indirect or dural carotid cavernous fistulas are abnormal connections between the cavernous sinus and meningeal branches of the external and/or internal carotid arteries. Most of them are idiopathic and occurs spontaneously. Symptoms vary from a tiny episcleral injection to a severe visual loss. Conservative therapy is recomended in cases with few symptoms and no leptomeningeal drainage, as spontaneous resolution is not infrequent. Whenever symptoms worsen, treatment of the fistula should be prescribed. Nowadays, transvenous endovascular treatment consisting of packing the cavernous sinus is the first choice. In most cases, cavernous sinus can be approached through the inferior petrosal sinus. However, sometimes that is not possible, and an approach directly through the superior ophthalmic vein could be necessary. We report a case of a patient with a dural carotid cavernous fistula treated with embolization of the cavernous sinus through the ophthalmic vein.

Embolización de fístula carótido cavernosa indirecta a través de la vena oftálmica superior / Embolization of indirect carotid-cavernous sinus fistula through the ophthalmic vein

Las fístulas carótido cevernosas (FCC) indirectaso durales son comunicaciones entre el seno cavernoso y ramas extradurales de la arteria carótida interna, la carótida externa o ambas. La mayoría de las FCC indirectas son idiopáticas y aparecen espontáneamente. Los síntomas pueden variar desde una leve inyección conjuntival y escleral hasta la reducción severa de la agudeza visual. En casos poco sintomáticos y sin drenaje leptomeníngeo, el tratamiento conservador estaría indicado inicialmente, pues existe la posibilidad del cierre espontáneo de la fístula. Cuando la sintomatología progresa, requieren algún tipo de tratamiento para cerrarla. Hoy en día, el tratamiento endovascular es el de elección, y la vía transvenosa, con sellado o empaquetado del SC, ha demostrado mayor efectividad que la transarterial. En la mayoría de los casos se puede acceder al SC a través del seno petroso inferior. Sin embargo, en ocasiones no es posible el acceso a la FCC por vía venosa transfemoral, siendo necesario un abordaje directo a la vena oftálmica superior (VOS). Presentamos un caso de FCC indirecta tratada mediante abordaje directo a la VOS y embolización del seno cavernoso

Indirect or dural carotid cavernous fistulas are abnormal connections between the cavernous sinus and meningeal branches of the external and/or internal carotid arteries. Most of them are idiopathic and occurs spontaneously. Symptoms vary from a tiny episcleral injection to a severe visual loss. Conservative therapy is recommended in cases with few symptoms and no leptomeningeal drainage, as spontaneous resolution is not infrequent. Whenever symptoms worsen, treatment of the fistula should be prescribed. Nowadays, transvenousendo vascular treatment consisting of packing the cavernous sinus is the first choice. In most cases, cavernous sinus can be approached through the inferior petrosal sinus. However, sometimes that is not possible, and an approach directly through the superior ophthalmic vein could be necessary. We report a case of a patient with a dural carotid cavernous fistula treated with embolization of the cavernous sinus through the ophthalmic vein

[Subarachnoid hemorrhage caused by a dissecting carotid artery aneurysm]. / Hemorragia subaracnoidea como forma de presentación de aneurisma disecante carotídeo.

Dissecting aneurysms of the carotid artery as a cause of subarachnoid hemorrhage are rare. However, the association of arterial dissection with the etiology of some aneurysms of the dorsal or anterior wall of the carotid artery, carotid trunk or "blister-like" aneurysms has increased the interest in the description of dissecting aneurysms, as they are difficult to treat and require non-habitual surgical techniques. We present the case of a patient that presented with a poor grade subarachnoid hemorrhage secondary to a right carotid artery dissecting aneurysm characterised in angiography by a carotid artery stenosis accompanied by a post-stenotic dilatation and the finding of a saccular aneurysm that increased in size in the follow-up study. A carotid occlusion test showed an asymmetry in the opacification of the venous phase indicating the need for a revascularization procedure prior to arterial sacrifice. A high flow EC-IC bypass was performed using a saphenous vein graft prior to right carotid artery occlusion without morbidity. Eight months after the procedure the patient is free of neurological deficit. Control image studies demonstrate the resolution of the carotid lesion and the bypass permeability. We discuss the difficulties in the diagnosis of these aneurysms, their clinical and imaging characteristics and the problems related to their treatment as they often require arterial sacrifice with or without prior cerebral revascularization.

Hemorragia subaracnoidea como forma de presentación de aneurisma disecante carotídeo / Subarachnoid hemorrhage caused by a disecting carotid artery aneurysm

Las disecciones carotídeas se presentan con muy poca frecuencia en forma de hemorragia subaracnoidea. Sin embargo, la implicación de la disección arterial en la patogenia de algunos aneurismas de la pared dorsal o anterior de la carótida, tronco carotídeo y aneurismas“blister-like”, ha hecho que cobre interés la descripción de los aneurismas disecantes, ya que con frecuencia son lesiones de difícil tratamiento y requieren de técnicas quirúrgicas no habituales. Presentamos el caso de una enferma que debutó con una hemorragia subaracnoidea en mal grado clínico secundaria a un aneurisma disecante de la carótida interna derecha, caracterizado por la presencia en el estudio angiográfico de una estenosis carotídea asociada a una dilatación postestenótica y al hallazgo de una lesión sacular que creció en el estudio de control. Se realizó un test de oclusión carotídea que mostró una asimetría en la aparición del drenaje venoso que determinó la conveniencia de practicar un by-pass extraintracraneal de alto flujo con injerto de safena para su tratamiento mediante sacrificio de la carótida interna. Ocho meses tras la cirugía la enferma no presenta focalidad neurológica alguna y los estudios de imagen muestran una resolución de la lesión carotídea con permeabilidad del bypass. Se discuten las dificultades en el diagnóstico de estos aneurismas, sus características clínicas y radiológicas y los problemas en su tratamiento que casi siempre requieren de sacrificio arterial con o sin revascularización cerebral previa

Dissecting aneurysms of the carotid artery as a cause of subarachnoid hemorrhage are rare. However, the association of arterial dissection with the etiology of some aneurysms of the dorsal or anterior wall of the carotid artery, carotid trunk or “blister-like” aneurysms has increased the interest in the description of dissecting aneurysms, as they are difficult to treat and requiren on-habitual surgical techniques. We present the case of a patient that presented with a poor grade subarachnoid hemorrhage secondary to a right carotid artery dissecting aneurysm characterised in angiography by a carotid artery stenosis accompanied by a post-stenotic dilatation and the finding of a saccular aneurysm that increased in size in the follow-up study. A carotid occlusion test showed an asymmetry in the opacification of the venous phase indicating the need for a revascularization procedure prior to arterial sacrifice. A high flow EC-IC bypass was performed using a saphenous vein graft prior to right carotid artery occlusion without morbidity. Eight months after the procedure the patientis free of neurological deficit. Control image studies demonstrate the resolution of the carotid lesion and the bypass permeability. We discuss the difficulties in the diagnosis of these aneurysms, their clinical and imaging characteristics and the problems related to their treatment as they often require arterial sacrifice with or without prior cerebral revascularization

[Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina]. / Distribución de tipo capsular y sensibilidad antimicrobiana de Streptococcus agalactiae productores de infecciones en Argentina.

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

Cytomegalovirus pneumonia after bone marrow transplantation: high resolution CT findings.

Cytomegalovirus (CMV) pneumonia is one of the most common pulmonary complications after bone marrow transplantation (BMT). We describe the high resolution CT (HRCT) findings of 13 patients with CMV pneumonia diagnosed after allogenic BMT. The study included 13 consecutive patients who developed CMV pneumonia after BMT and who had HRCT of the chest performed within 24 h of the onset of symptoms. HRCT scans were reviewed by two radiologists who assessed pattern and distribution of findings. There were nine male and four female patients, ranging from 9 years to 56 years of age (mean age 33 years). BMT was performed for treatment of chronic myelogenous leukaemia (54%), severe aplastic anaemia (23%), acute myelogenous leukaemia (15%) and Fanconi's anaemia (8%). The time elapsed until diagnosis ranged from +18 days to +405 days (median of 54 days, mean +81.6 days). The predominant patterns of abnormality on HRCT scans were ground-glass opacities (69%), small centrilobular nodules (69%) and air-space opacities (54%). The abnormalities were distributed in the central and peripheral zones of the lungs in six cases, only in the periphery in four cases, and only in the central zone in three cases. In all cases the lung lesions were bilateral, and asymmetry was observed in seven cases. The authors conclude that the most common HRCT findings in patients with CMV pneumonia after BMT consist of bilateral asymmetric ground-glass, air-space opacities and small centrilobular nodules.

Distribución de tipo capsular y sensibilidad antimicrobiana de Streptococcusagalactiae productores de infecciones en Argentina / Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina

Streptococcus agalactiae es una bacteria colonizante que ha emergido en los últimos años como causante de infecciones neonatales, perinatales y en pacientes con compromiso inmunológico. La caracterización del polisacárido capsular, de las proteínas de superficie (c, X, R), así como el análisis de marcadores moleculares, permiten su clasificación en serotipos y genotipos. Esto resulta de utilidad para fines epidemiológicos y para estudios de virulencia de la bacteria. El objetivo de este trabajo fue conocer los serotipos prevalentes y la sensibilidad antimicrobiana de aislamientos provenientes de procesos infecciosos en pacientes de distintas zonas de Argentina. En la muestra analizada se obtuvo predominio de los serotipos Ia y III, seguido de II y IV. Todas las cepas resultaron sensibles a penicilina. Se observó 6% de resistencia a eritromicina y 4,5% a clindamicina. En 3 de las cepas se detectó fenotipo MLS (resistencia a macrólidos, lincosaminas y estreptograminas) constitutiva y en una cepa, resistencia MLS inducible. Los resultados logrados en este estudio destacan la importancia de efectuar un relevamiento de los serotipos más frecuentes en nuestro país en vistas a la prevención de esta infección con una vacuna que realmente sea eficaz, como así también el conocimiento de la sensibilidad antimicrobiana para lograr éxito terapéutico en los tratamientos.

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

Distribución de tipo capsular y sensibilidad antimicrobiana de Streptococcus agalactiae productores de infecciones en Argentina. / [Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina]

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6

of resistance to erythromycin and a 4.5

to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

Intoxication of Crotalaria pallida seeds to growing broiler chicks.

The adverse effects of feeding Crotalaria pallida (CP) seeds to chicks was investigated in a 21-day randomized trial of 4 dietary treatments (control, 1,2 and 3% ground CP seeds). Mortality rates in birds fed 0, 1, 2, and 3% dietary CP were 0, 2.1, 6.2, and 16.7%, respectively. Body weight gain and feed efficiency were adversely affected by all levels of inclusion of CP seeds, but feed intake was decreased only by dietary levels of 2 and 3%. Dietary CP of 2 and 3% increased the relative weight of lung, heart and spleen. Relative liver weight was increased by 2% dietary CP, but decreased by 3% CP. At day 14, serum GGT was increased by 2 and 3% dietary CP; serum ALT was significantly increased by 3% CP. No differences in ALT, AST or GGT were observed at day 21. Dietary levels equal to or greater than 1% CP are toxic for growing broiler chicks.

Differential role of the Mu B protein in phage Mu integration vs. replication: mechanistic insights into two transposition pathways.

The Mu B protein is an ATP-dependent DNA-binding protein and an allosteric activator of the Mu transposase. As a result of these activities, Mu B is instrumental in efficient transposition and target-site choice. We analysed in vivo the role of Mu B in the two different recombination reactions performed by phage Mu: non-replicative transposition, the pathway used during integration, and replicative transposition, the pathway used during lytic growth. Utilizing a sensitive PCR-based assay for Mu transposition, we found that Mu B is not required for integration, but enhances the rate and extent of the process. Furthermore, three different mutant versions of Mu B, Mu BC99Y, Mu BK106A, and Mu B1-294, stimulate integration to a similar level as the wild-type protein. In contrast, these mutant proteins fail to support Mu growth. This deficiency is attributable to a defect in formation of an essential intermediate for replicative transposition. Biochemical analysis of the Mu B mutant proteins reveals common features: the mutants retain the ability to stimulate transposase, but are defective in DNA binding and target DNA delivery. These data indicate that activation of transposase by Mu B is sufficient for robust non-replicative transposition. Efficient replicative transposition, however, demands that the Mu B protein not only activate transposase, but also bind and deliver the target DNA.

Analysis of the mutational spectrum of the FGFR2 gene in Pfeiffer syndrome.

Pfeiffer syndrome (PS) is one of the classical craniosynostosis syndromes correlated with specific mutations in the human fibroblast growth factor receptor (FGFR) genes, FGFR1 and FGFR2. In this study, we set out to examine the exons in FGFR2 most commonly associated with mutations in PS, exons IIIa and IIIc, in a panel of 78 unrelated individuals with PS by the most sensitive method (direct DNA sequencing). We have identified a total of 18 different mutations among 40 patients; eight of these mutations have not been previously described. The mutational spectrum displays a non-random character with the frequent involvement of cysteine codons.

[Industrial pollution due to organic solvents as a cause of teratogenesis]. / Contaminación industrial con solventes orgánicos como causa de teratogénesis.

OBJECTIVE: To inform of a new teratogenic syndrome in human beings and its confirmation in rats. MATERIAL AND METHODS: The study comprised three phases: a field study; a case-control study; and a genetic epidemiology study, aiming at identifying the causes of the occurrence of congenital malformations and psychomotor retardation in the city of Matamoros, Tamaulipas. The second-phase clinical multidisciplinary study was carried out at a general hospital, to conduct a comprehensive evaluation of patients identified during the first phase and offer them the necessary treatment. The third-phase experimental study was done in rats in order to confirm the teratogenic effect of the agents detected in the first phase. RESULTS: A total of 44 patients had a peculiar phenotype and mental retardation of varying degrees, all children of ex-workers of the same factory who were in direct contact, without protection, with organic solvents (methyl cellosolve and ethylene glycol). In the clinical study a syndrome was delineated, previously unreported, consisting of a peculiar facies, mental retardation, and musculo-skeletal and sensorial abnormalities. In the experimental study it was demonstrated that both methyl cellosolve and ethylene glycol cause cranio-facial, musculo-skeletal and central nervous system abnormalities, which confirmed the teratogenic effect of these solvents. CONCLUSIONS: The results of this study establish the existence of a new teratogenic syndrome in humans, produced by methyl cellosolve and ethylene glycol, whose teratogenic capacity had not been reported previously.

Changing subunit composition of heteromeric NMDA receptors during development of rat cortex.

Activation of the N-methyl-D-aspartate (NMDA) receptor is important for certain forms of activity-dependent synaptic plasticity, such as long-term potentiation (reviewed in ref. 1), and the patterning of connections during development of the visual system (reviewed in refs 2, 3). Several subunits of the NMDA receptor have been cloned: these are NMDAR1 (NR1), and NMDAR2A, 2B, 2C and 2D (NR2A-D). Based on heterologous co-expression studies, it is inferred that NR1 encodes an essential subunit of NMDA receptors and that functional diversity of NMDA receptors in vivo is effected by differential incorporation of subunits NR2A-NR2D. Little is known, however, about the actual subunit composition or heterogeneity of NMDA receptors in the brain. By co-immunoprecipitation with subunit-specific antibodies, we present here direct evidence that NMDA receptors exist in rat neocortex as heteromeric complexes of considerable heterogeneity, some containing both NR2A and NR2B subunits. A progressive alteration in subunit composition seen postnatally could contribute to NMDA-receptor variation and changing synaptic plasticity during cortical development.